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Friday, January 23, 2015

Minimally Conscious State' Suddenly Speaks

The take home is that a victim of catatonia will respond to a range of sedatives allowing him to communicate. This is no cure but the therapeutic value is obvious. Just been able to communicate and confirm things with doctors is a huge leap forward.

We do not know yet, but the incentive of communication may even stimulate resolution. One would hope so.

Additionally this shows us effective tools to rest out on other comatose individuals. Even nothing happening tells us something.

A man in Italy who was in what doctors call a "minimally conscious
state" for nearly two years unexpectedly regained full consciousness and
the ability to talk, according to a new report of his case.

The man woke up after he was given a drug normally used as a sedative
before surgery and other medical procedures, the case report showed.

The 43-year-old man was admitted to a hospital after a car accident, and was in a coma for 40 days. People who are comatose are completely unconscious — they have no sleep/wake cycles, and do not respond to their surroundings in any way.

The man awoke from the coma but remained in a "minimally conscious state,"
which means that although he remained largely unable to communicate or
move, he was able to voluntarily open and close his eyes, and reach for
and touch objects. He also had a sleep-wake cycle.

When he was discharged from the hospital 10 months later, he still did
not talk or communicate with other people, nor did he respond to simple
commands asking him to, for instance, close his eyes.

Over the next year, the man's cognitive ability
started to decline; his movements became abnormally slow; and he began
to engage in aimless, repetitive behaviors, such as clapping.

But then, about two years after the accident, the man's doctors wanted
to examine his brain using a CT scan. To do the scan, they gave the man a
mild sedative called midazolam.

A few minutes later, the man began to talk and interact with others.

"He talked by cellphone with his aunt and congratulated his brother
when he was informed of his graduation; he recognized the road leading
to his home," the researchers who treated the man wrote in the case
report. However, the man did not remember the accident, and he was not
aware of the way it had affected his health, they wrote.

This is the first report of midazolam having an "awakening" effect, the researchers said.

However, the effect wore off after about two hours, and the man
returned to his previous state, unresponsive to the environment,
according to the study.

To see whether it was indeed the drug that caused the brief improvement
in the man's condition, the researchers gave the man midazolam again.
Several minutes following the administration, the patient began to
interact with his brother and answered questions the researchers asked
him. He was also able to calculate simple math problems, such as 100
minus 7, as well as read and understand simple sentences, such as "Close
your eyes."

This time around, the researchers scanned the man's brain before,
during and after the administration of midazolam, and identified the
locations within the brain that were affected by the drug. They found
that those regions previously had been linked to the symptoms of
catatonia, which is a state of unresponsiveness to stimuli that is often
associated with schizophrenia.

Moreover, the researchers noted, patients with catatonia have been
reported to respond to midazolam in the past. The symptoms of the man in
this report were similar to those of catatonic patients, which may mean
that he was indeed catatonic and therefore responded to the drug,
according to the study.

However, it is not completely clear whether the patient did indeed
suffer from catatonia or whether his condition merely included certain catatonic symptoms, the researchers wrote.

Although midazolam was effective as a short-term method of treating the
man's symptoms, the researchers said they could not keep giving it to
him. Usually, the drug is given only to people in intensive-care units,
where they can be monitored continuously, said Dr. Maria Chiara
Carboncini, medical director of the Brain Injury Unit in the University
Hospital of Pisa's Department of Neuroscience in Italy, who treated the
patient and was a co-author of the report.

The researchers tried treating the man with another drug called
lorazepam, which belongs to the same class of drugs as midazolam but can
be administered more easily, as the patient does not have to be
monitored continuously, Carboncini told Live Science.

However, after several days of therapy with lorazepam, the man became
agitated and aggressive. His doctors switched him to carbamazepine, a
drug used to treat people with epilepsy. This drug allowed the man to
"maintain the improvement of his ability to interact and communicate
with people," Carboncini said.

The study was published in the November issue of the journal Restorative Neurology and Neuroscience.

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Apr 2017 - 4.1 Mil Pg Views, March 2013 - Posted my paper introducing CLOUD COSMOLOGY & NEUTRAL NEUTRINO rigorously described as the SPACE TIME PENDULUM, September 2010 I am pleased to report that my essay titled A NEW METRIC WITH APPLICATIONS TO PHYSICS AND SOLVING CERTAIN HIGHER ORDERED DIFFERENTIAL EQUATIONS' has been published in Physics Essays(AIP) and appeared in their June 2010 quarterly. 40 years ago I took an honors degree in applied mathematics from the University of Waterloo. My interest was Relativity and my last year there saw me complete a 900 level course under Hanno Rund on his work in relativity,as well as differential geometry(pure math) and of course analysis. I continued researching new ideas and knowledge since that time and I have prepared a book for publication titled Paradigms Shift&. I maintain my blog as a day book and research tool to retain data and record impressions and interpretations on material read. Do join my blog and receive Four items of interest daily Monday through Saturday.